Sociodemographic factors influencing antenatal booking time at antenatal clinic of mother and child hospital, Akure, Ondo State, Nigeria

Wilson Shina Adenikinju; Bobo Temidayo Israel; Tomisin Mathew Adaja; Catherine Iyabo Akinsipe; Olorunfemi Oludele Owa

doi:10.18203/2320-1770.ijrcog20263970

Authors

Wilson Shina Adenikinju Department of Obstetrics and Gynaecology, College of Health Sciences, Federal University of Technology Akure, Akure, Nigeria https://orcid.org/0000-0003-4215-2662
Bobo Temidayo Israel Department of Obstetrics and Gynaecology, College of Health Sciences, Bowen University, Iwo
Tomisin Mathew Adaja Department of Chemical Pathology, College of Health Sciences, Federal University of Technology Akure, Nigeria https://orcid.org/0000-0003-3553-3651
Catherine Iyabo Akinsipe Department of Obstetrics and Gynaecology, State Specialist Hospital Ikere Ekiti, Ekiti State, Nigeria
Olorunfemi Oludele Owa Department of Obstetrics and Gynaecology, Federal Medical Centre Owo, Ondo State, Nigeria

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20263970

Keywords:

Antenatal care, Booking time, Nigeria, Parity, Sociodemographic factors

Abstract

Background: Early initiation of antenatal care (ANC) is crucial for optimal maternal and fetal outcomes. The World Health Organization (WHO) 2016 model recommends the first contact during the first trimester, and at least eight contacts overall. Nigeria continues to experience high maternal mortality, with 512 deaths per 100,000 live births reported in the 2018 NDHS.

Methods: A cross-sectional study was conducted at Mother and Child Hospital, Akure, between June 2023 and April 2024. Systematic random sampling recruited 1,043 pregnant women presenting for booking. Data on age, parity, education, occupation, spouse characteristics, and religion were collected via structured questionnaire. Gestational age at booking was categorized by trimester. Chi-square tests examined associations (p<0.05).

Results: Mean age was 32.0±4.93 years. Booking distribution: first trimester 20.6% (n=215), second trimester 62.4% (n=651), third trimester 17.0% (n=177). Maternal age was significantly associated with booking time (χ²=54.926, p=0.018): women aged 15-25 years had the highest first-trimester booking (28.6%) versus 20.1% for 26-35 years and 18.1% for 36-45 years. Parity was also significant (χ²=17.980, p=0.008): nulliparous women booked earliest (25.3% first trimester), while grand-multiparous women had the lowest (16.7%) and highest third-trimester booking (66.7%, standardized residual +2.99, p<0.01). Maternal education, spouse education, maternal occupation, spouse occupation, and religion showed no statistically significant association.

Conclusions: Only one in five women booked in the first trimester. Younger age and nulliparity predicted earlier booking, while grand-multiparity predicted severe delay. Interventions must target experienced mothers who may underestimate risk.

References

World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience, 2016. Available at: https://www.who.int/publications/i/item/9789241549912. Accessed 01 February 2026.

World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience -Highlights and Key Messages, 2018. Available at: https://www.who.int/publications/i/item/WHO-RHR-18.02. Accessed 01 February 2026.

Adekanle D, Isawumi A. Late antenatal care booking and its predictors among pregnant women in south western Nigeria. Online L Heal Allied Scs. 2008;7(1):4.

Aduloju OP, Akintayo AA, Ade-Ojo IP, Awoleke JO, Aduloju T, Ogundare OR. Gestational age at initiation of antenatal care in a tertiary hospital, Southwestern Nigeria. Niger J Clin Pr.2015;19(6):772-7.

Some A, Baguiya A, Coulibaly A, Bagnoa V. Prevalence and factors associated with late antenatal care visits in Kaya Health District, Burkina Faso. Afr J Reprod Heal. 2020;24(2):19-26.

Njiku F, Wella HL, Sariah A, Protas J. Prevalence and Factors associated with late antenatal care visit among pregnant women in Lushoto, Tanzania. Tanzan J Health Res. 2017;19(3):1-6.

Ndidi EP, Oseremen IG. Reasons given by pregnant women for late initiation of antenatal care in the Niger Delta, Nigeria. Ghana Med J. 2010;44(2):47-51.

Onoh RC, Umeora OU, Agwu UM, Ezegwui HU, Ezeonu PO, Onyebuchi AK. Pattern and determinants of antenatal Bookiung at Abakaliki Southeast Nigeria. Ann Med Health Sci Res. 2012;2(2):169-75.

Manzi A, Munyaneza F, Mujawase F, Banamwana L, Sayinzoga F, Thomson DR, et al. Assessing predictors of delayed antenatal care visits in Rwanda: a secondary analysis of Rwanda demographic and health survey 2010. BMC Pregnan Childb. 2014;14(1):290.

Wolde HF, Tsegaye AT, Sisay MM. Late initiation of antenatal care and associated factors among women in Addis Zemen primary hospital, South Gondar, Ethiopia. Reprod Heal. 2019;16(1):1-8.

Aung TZ, Oo WM, Khaing W, Lwin N, Dar HT. Late initiation of antenatal care and its determinants: A hospital based cross-sectional study. Int J Community Med Public Heal. 2016;3(4):900-905.

Adeyemi AS, Owolabi AT, Fakunle BF. Antenata care booking pattern in a tertiary hospital in south-west Nigeria. Trop J Obstet Gynae. 2017;34(1):19-24.

Ijadunola KT, Fatusi AO, Orji EO, Adeyemi AB, Owolabi OO, Ojofeitimi EO, et al. A comparative study of the pattern of antenatal care booking in a Nigerian teaching hospital. Niger J Med. 2010;19(3):294-8.

Tolefac PN, Halle-Ekane GE, Agbor VN, Sama CB, Ngwasiri C, Tebeu PM. Why do pregnant women present late for their first antenatal care consultation in Cameroon? Matern Health Neonatol Perinatol. 2017;3:29.

Nwagha UI, Ugwu OV, Anyaehie US. The influence of parity on the gestational age at booking among pregnant women in Enugu, South East Nigeria. Niger J Physiolog Sci. 2008;23(1-2).

Mahiti GR, Chombo S, Luoga P. Socio-demographic correlates of booking antenatal care in first trimester among pregnant women in Tanzania. Insights from Tanzania demographic health survey 2022. Front Reproduct Heal. 2025;7:1669621.

Okedo-Alex IN, Akamike IC, Ezeanosike OB, Uneke CJ. Determinants of antenatal care utilisation in sub-Saharan Africa: a systematic review. BMJ Open. 2019;9(10):e031890.

Exavery A, Kanté AM, Hingora A, Mbaruku G, Pemba S, Phillips JF. How mistimed and unwanted pregnancies affect timing of antenatal care initiation in three districts in Tanzania. BMC Pregn Childb. 2013;13(1):35.